Semaglutide 2.4 mg long-term clinical outcomes in patients with obesity or overweight: a real-world retrospective cohort study in the United States (SCOPE 12 months)

Postgrad Med. 2025 Apr-May;137(3-4):251-260. doi: 10.1080/00325481.2025.2482274. Epub 2025 Mar 27.

Abstract

Objectives: To evaluate the effectiveness of semaglutide 2.4 mg for weight reduction and improvement in cardiometabolic biomarkers at 52 and 68 weeks in a real-world setting in the United States.

Methods: This noninterventional, retrospective cohort study used the Komodo Health database and included adults with obesity or overweight with ≥1 weight-related condition who initiated treatment with semaglutide 2.4 mg between June 2021 and August 2022 and remained on treatment for 1 year. A paired t-test was used to assess changes in weight, body mass index (BMI), and cardiometabolic biomarkers (systolic blood pressure [SBP], diastolic blood pressure [DBP], glycated hemoglobin [HbA1c], HDL [high-density lipoprotein] cholesterol, LDL [low-density lipoprotein] cholesterol, and triglycerides) from baseline to 52-week and 68-week follow-up.

Results: Among 4,424 eligible patients, 77% were women and the mean (SD) age was 46.7 (10.0) years and BMI was 36.6 (3.6) kg/m2. Dyslipidemia and hypertension were the most common obesity-related comorbidities at baseline. The mean (%) change in weight from baseline was -15.5 kg (-14.5%; p < 0.001; n = 594) at 52 weeks and -15.9 kg (-14.8%; p < 0.001; n = 391) at 68 weeks. The mean change in BMI from baseline was - 4.8 kg/m2 (n = 1124) at 52 weeks and - 4.9 kg/m2 (n = 700) at 68 weeks. At 52weeks, statistically significant improvements in mean values were observed for SBP (-6.3 mmHg), DBP (-3.1 mmHg), HbA1c (-0.4%), LDL cholesterol (-8.1 mg/dL), and triglycerides (-38.4 mg/dL) (all p < 0.001). Mean change at 52 weeks for HDL cholesterol was 1.0 mg/dL; p = 0.109. Results at 68 weeks were similar.

Conclusions: In this retrospective cohort study, the real-world effectiveness of semaglutide 2.4 mg was demonstrated by reductions in weight and BMI along with improvements in BP, HbA1c, and lipid panel among patients with obesity or overweight.

Keywords: Obesity; antiobesity agents; body mass index; evidence-based practice; weight loss.

Plain language summary

We studied 4,424 adults with excess body weight in the United States who took semaglutide 2.4 mg (Wegovy®) for a full year. Semaglutide is a medicine that can help people lose weight and improve other health conditions. We looked at how much weight people lost and how certain health markers, like laboratory values and blood pressure, improved. We used information about doctor visits and insurance claims from a large health database.Most people taking semaglutide 2.4 mg were female and the average age was 47 years. After 1 year, weight was reduced by 15.5 kg (about 34 pounds). Most people (88%) lost at least 5% of their body weight. Almost three-quarters of people (72%) lost 10% or more of their weight. Nearly half lost 15% or more. More than 1 of every 4 people lost 20% or more of their weight.Other health improvements were also seen. Blood pressure was lowered by an average of 6.3 mmHg for systolic blood pressure (the top number) and 3.1 mmHg for diastolic blood pressure (the bottom number). ‘Bad’ LDL cholesterol and triglycerides (fats in the blood that can increase heart disease risk) also decreased.We found that treatment with semaglutide 2.4 mg helped people lose a large amount of weight and improved many other factors important to heart health that were measured after 1 year of treatment.

MeSH terms

  • Adult
  • Biomarkers / blood
  • Blood Pressure / drug effects
  • Body Mass Index
  • Female
  • Glucagon-Like Peptide 1
  • Glucagon-Like Peptides* / administration & dosage
  • Glucagon-Like Peptides* / therapeutic use
  • Glycated Hemoglobin / analysis
  • Humans
  • Male
  • Middle Aged
  • Obesity* / drug therapy
  • Overweight* / drug therapy
  • Retrospective Studies
  • Semaglutide
  • Treatment Outcome
  • United States
  • Weight Loss / drug effects

Substances

  • Glucagon-Like Peptides
  • Glycated Hemoglobin
  • Biomarkers
  • Glucagon-Like Peptide 1
  • Semaglutide